April is National Alcohol Awareness Month, and Thursday, April 7, 2022 was National Alcohol Screening Day. Alcohol has been around since man learned to crush grapes. In fact, residue of alcoholic beverage consisting of rice, honey, and hawthorn fruit or grape was found in pottery shards from China dating back to 7000-6600 BC. Drinking alcohol has long been an acceptable past time. The euphoric, mind- and mood-altering properties is attractive to people. However, the difference between the occasional drink and intoxication has always been at the root of alcoholism. Intoxication and drunkenness has always been demonized, from Ancient Egyptians to Greek philosophers Plato and Aristotle, to modern religious organizations; all have cautioned against excessive drinking.
Dr. Benjamin Rush, one of our Founding Fathers, recognized alcoholism as a disease that should be treated as early as 1784. Up into the 20th century, treatments for alcoholism ranged from bizarre to alarming. Proprietary home cures, double chloride of gold, and belladonna to name a few. Freud recommended cocaine for the treatment of alcoholism and even the use of barbiturates was common in treatment.
Throughout all this, there have been debate on the cause of alcoholism. Some feel it is a moral weakness, lack of will power, and the result of poor decision making on the part of alcoholics. Others feel it is a medical and psychiatric illness, an allergy of the body and obsession of the mind. Regardless of the cause, the state of successful treatment through the first third of the 20th Century was considered hopeless by physicians and those alcoholics that did not die from their disease were institutionalized. Dr. Carl Jung was reported to believe that those with a chronic alcoholic mind never recovered without what he called a vital spiritual experience.
It was not until 1935, Bill Wilson, an American businessman, and Dr. Bob Smith, met in Akron, Ohio, that things started to change. They were both alcoholics and from this meeting Alcoholics Anonymous was born and the familiar 12 step recovery program that is the basis of most modern addiction treatments began to be implemented
Although Alcoholics Anonymous and other treatment centers have had a profound impact on alcoholism treatment, the problem still exists. In fact, the problem of alcoholism is on the rise. Shockingly, the number and rate of alcohol related deaths between 2019 and 2020 increased by 25% from 78,927 to 99,017. To make matters worse, this number may be significantly underestimated due to death certificates not listing alcoholism or not reporting alcohol because it is unclear if alcohol was a contributing factor to death. To put the reported number of alcohol deaths (99, 017) in perspective, that is almost twice the number of deaths due to colon cancer in the US in 2020 (51,869). The likely cause of this dramatic increase is the COVID-19 pandemic. We all recall the numerous memes, posts, and jokes on social media and elsewhere about the consumption of great amounts of alcohol as most people were stuck in their homes sheltering in place. In addition, people in treatment for their addictions were unable or having difficulty meeting with counselors or other treatment groups to maintain their sobriety.
The social stigma associated with alcoholism: that it is a psychiatric illness, or caused by weak moral character, or lack of individual will power, unfortunately prevents many from seeking care. In fact, many people may be concerned that they drink too much but are afraid of admitting this to their physicians. They may fear what others may think, the consequences at work, and with family and friends. Unfortunately, many people with alcohol problems will not seek help until more serious consequences of their dinking, more serious than they could imagine (i.e., legal, or medical) occur.
There are many screening tools available online for self-assessment to determine if you may have a problem with alcohol. AUDIT-C asks three questions: How often did you have a drink containing alcohol in the past year? How many drinks containing alcohol did you have on a typical day when you were drinking in the past year? How often did you have six or more drinks on one occasion in the past year? Scores are graded by response and a score of 4 or more is indicative of alcohol misuse, not necessarily alcoholism. Alcoholics Anonymous has a self-assessment entitled “Is A.A. for you?” that is also available online. This asks 12 questions that were developed by alcoholics based on their own personal experiences with alcohol.
While most people who consume alcohol never develop a problem with alcohol, many do not realize the effect alcohol can have on their lives. Alcohol screening tests provide an opportunity for education and may reveal areas of concern that may not be evident. If you are concerned about your drinking habits or suspect someone you care about may have a problem, these screening tests are a tool to begin discussions with your physician or caregivers. Take advantage of them and all the available resources on the internet and in our community.
Dr. James Lee serves as the Coroner of Winn Parish. He is a General Surgeon and Surgical Oncologist who has been practicing in Winnfield for over ten years. Dr. Lee attended the University of Colorado for his medical degree. He completed his residency in Surgery at the University of Oklahoma before completing a fellowship in Surgical Oncology and Endoscopy at Roswell Park Cancer Institute in Buffalo, NY. Dr. Lee and his wife Scarlett live in Winnfield with their son and are active in the community.